Provider Demographics
NPI:1780710814
Name:YANCEY, GEORGE STANCIL (LCSW)
Entity type:Individual
Prefix:
First Name:GEORGE
Middle Name:STANCIL
Last Name:YANCEY
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4932 WINDY HILL DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27609-4930
Mailing Address - Country:US
Mailing Address - Phone:919-215-0536
Mailing Address - Fax:
Practice Address - Street 1:4932 WINDY HILL DR
Practice Address - Street 2:SUITE A
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-4930
Practice Address - Country:US
Practice Address - Phone:919-215-0536
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCCO43431041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical